Provider Demographics
NPI:1225676539
Name:MAREE, NADYA (LPC, ATR-BC, CAADC)
Entity Type:Individual
Prefix:
First Name:NADYA
Middle Name:
Last Name:MAREE
Suffix:
Gender:F
Credentials:LPC, ATR-BC, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:PA
Mailing Address - Zip Code:19405-1534
Mailing Address - Country:US
Mailing Address - Phone:267-294-1988
Mailing Address - Fax:
Practice Address - Street 1:1364 WELSH RD
Practice Address - Street 2:
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454-1913
Practice Address - Country:US
Practice Address - Phone:215-767-7096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA17-397221700000X
PAPC009878101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist